NASELFAST 55MCG/DOSE NASAL SP 120/SPRAYS

Indications

Approved Uses

Treatment of nasal symptoms of seasonal allergic rhinitis and perennial allergic rhinitis.

Dosage & Administration

Dosing by Condition

Allergic Rhinitis (Adults & Children ≥12 years): Start with 220 mcg/day (2 sprays per nostril once daily). Once symptoms are controlled, reduce to 110 mcg/day (1 spray per nostril once daily). Allergic Rhinitis (Children 6-11 years): Start with 110 mcg/day (1 spray per nostril once daily). May increase to 220 mcg/day if needed, then reduce to 110 mcg/day once symptoms are controlled. Allergic Rhinitis (Children 2-5 years): 110 mcg/day (1 spray per nostril once daily).

Initial Dose

Adults and adolescents ≥12 years: 2 sprays (110 mcg) per nostril once daily (total 220 mcg/day)

Maintenance Dose

1 spray (55 mcg) per nostril once daily (total 110 mcg/day) once adequate control is achieved

Maximum Dose

Adults and children 12 years and older: 220 mcg per day. Children 6-11 years: 220 mcg per day. Children 2-5 years: 110 mcg per day.

Children's Dosage

Ages 6-11 years: 1 spray (55 mcg) per nostril once daily (110 mcg/day); max 2 sprays per nostril once daily (220 mcg/day). Ages 2-5 years: 1 spray per nostril once daily (110 mcg/day). Not recommended under 2 years of age

Dose Adjustment Notes

Use the lowest effective dose once symptoms are controlled; no routine dose adjustment is recommended for renal or hepatic impairment.

How to Take

For intranasal use only. Shake well before each use. Gently blow the nose. Prime the pump before first use (typically 5 sprays into the air away from the face) and re-prime if not used for about 2 weeks (typically 1 spray). Insert the nozzle into one nostril while closing the other, aim slightly outward/away from the nasal septum, and spray while breathing in gently (do not sniff hard). Repeat for the other nostril as directed. Avoid blowing the nose for ~15 minutes after dosing. Wipe the nozzle and replace the cap after use.

How to Prepare

Shake well; prime before first use with 5 sprays/actuations until a fine mist appears (away from the face). If not used for >2 weeks, re-prime with 1 spray.

Side Effects

Common Side Effects

Epistaxis (nosebleed), nasal irritation/burning/stinging, nasal dryness, sneezing, headache, pharyngitis (sore throat), cough.

Side Effect Frequency

Common (≥1%): epistaxis, headache, pharyngitis/upper respiratory symptoms, cough; local nasal irritation/burning/dryness may occur. Rare: nasal septal perforation, Candida infection; ocular effects (glaucoma/cataract) and HPA-axis suppression are uncommon/rare with recommended intranasal doses.

Safety & Warnings

Contraindications

Hypersensitivity to triamcinolone acetonide or any component of the formulation.

Warnings & Precautions

Avoid use with unhealed nasal ulcers or after recent nasal surgery/trauma until healed; monitor for Candida infection and for ocular effects (glaucoma/cataracts) with prolonged use; use caution in patients with infections (e.g., TB, untreated fungal/bacterial/viral infections including ocular herpes) due to immunosuppression; monitor growth in children with long-term use; avoid spraying into eyes; if inadequate response after ~1 week of OTC use or if prolonged use is needed, seek medical evaluation.

Age Restriction

OTC use: adults and children ≥2 years; supervised use in children 2-5 years (1 spray/nostril daily); do not use in children <2 years.

Special Populations

Pregnancy

Pregnancy Category C

Children

Ages 6-11 years: 1 spray (55 mcg) per nostril once daily (110 mcg/day); max 2 sprays per nostril once daily (220 mcg/day). Ages 2-5 years: 1 spray per nostril once daily (110 mcg/day). Not recommended under 2 years of age

Elderly

Standard adult dosing; no specific dose adjustment required

Kidney Impairment

No adjustment needed.

Storage & Patient Advice

Preparation Instructions

Shake well; prime before first use with 5 sprays/actuations until a fine mist appears (away from the face). If not used for >2 weeks, re-prime with 1 spray.

Stopping the Medicine

May be stopped without taper at recommended intranasal doses; for OTC self-care, seek medical advice if symptoms do not improve within 1 week or if continued use is needed beyond label duration.

Overdose

Acute intranasal overdose is unlikely to cause serious systemic toxicity; chronic excessive use may cause hypercorticism and/or HPA-axis suppression-manage by reducing to recommended dosing and providing supportive/medical evaluation if systemic effects occur.

Patient Counseling

Use once daily regularly (not just as needed); expect some relief within 1 day but full benefit in ~1-2 weeks. Shake before use; prime before first use and re-prime if unused ~2 weeks. Aim the spray away from the nasal septum and sniff gently; avoid blowing the nose for ~15 minutes after dosing. Do not exceed the labeled daily sprays. Seek advice if frequent nosebleeds/nasal sores occur, symptoms persist after a few weeks, or if vision changes occur. Avoid use after recent nasal surgery/trauma until healed. Store below 30°C.

Monitoring Requirements

For prolonged/repeated use: periodically examine nasal mucosa for irritation/ulceration/epistaxis; monitor growth in pediatric patients; monitor for ocular effects (blurred vision, cataract/glaucoma-consider intraocular pressure assessment in at-risk patients); consider adrenal suppression only with high-dose/prolonged use or interacting drugs.

Pharmacology

Mechanism of Action

Intranasal corticosteroid: binds glucocorticoid receptors in nasal mucosa to downregulate inflammatory gene transcription and mediator release, reducing mucosal inflammation and allergic symptoms.

Onset of Action

Some symptom improvement may occur within ~12-24 hours; maximum benefit typically requires regular daily use for about 1-2 weeks.

Duration of Effect

Approximately 24 hours (supports once-daily dosing).

Half-Life

Terminal elimination half-life is approximately 1.5 hours (88 minutes).

Bioavailability

Very low systemic bioavailability; generally reported as <1% after intranasal administration (systemic absorption is minimal).

Product Information

Available Dosage Forms

Nasal spray, metered-dose (nasal spray suspension).

Composition per Dose

Each spray (actuation): 55 mcg triamcinolone acetonide

Generic Availability

Yes

Symptom Target

Allergy, Congestion, Runny Nose

Sedating

No

Reviewed by Al Mujtama Pharmacy Medical Review Team. Last reviewed 20-08-2026